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Diagnostic advice, treatment options, multidisciplinary care and more

April 16, 2022

4 minute read

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April is IBS Awareness Month and highlights the importance of public education and health messages about the diagnosis, treatment, and quality of life for patients with Irritable Bowel Syndrome.

According to the International Foundation for Gastrointestinal Disorders, IBS affects nearly 45 million people in the United States and 10-15% of the world’s population. Although common, many people are undiagnosed and unaware that their symptoms can be managed. In addition, patients are often stigmatized and misunderstood, which has a significant impact on their quality of life.

IBS Awareness Month

Although the exact pathogenesis of IBS remains largely unknown, scientific evidence points to disruptions in the interaction between the gut, brain, and nervous system that can lead to changes in normal bowel function and produce symptoms ranging from mild inconvenience to severe debilitation.

In support of IBS Awareness Month, Healio has compiled eight recent reports on diagnostic advice, treatment updates, pain management and long-term care for patients with IBS.

Open-label placebo reduces pain in pediatric and adolescent functional gastrointestinal disorders

According to research published in JAMA Pediatrics.

“Although placebo responses likely play a role in virtually all clinical interventions, the use of deceptive placebos as stand-alone treatments has been widely discouraged due to ethical concerns about patient deception,” Samuel Nurko, MD, MPH, from the Center for Motility and Functional Gastrointestinal Disorders at Boston’s Children’s Hospital, and colleagues wrote. “Until recently, it was generally believed that blinding of the patient (via deception or concealment) was necessary to achieve placebo effects, but recent studies with adults suggest that honestly prescribed open-label placebo treatment can produce positive effects.” Read more.

Relistor produces lifeless laxation in patients with opioid-induced constipation

According to a study published in the Journal of Emergency Medicine.

“Methylnaltrexone (Relistor) works in the majority of patients with opioid-induced constipation within four hours, and its use does not alter the analgesic effects of the opioid,” W. Frank Peacock, MD, FACEP, FACC, lead author and research director at Baylor College of Medicine in Houston, Healio said. Read more.

Bile acid diarrhea affects bowel symptoms and quality of life in IBS-D

According to the study results, bile acid diarrhea had a significant impact on bowel symptoms and quality of life in IBS patients with diarrhea.

“We conclude that patients with [bile acid diarrhea (BAD)] had a higher BMI, was taking more anti-diarrheal agents, and had more severe and frequent diarrhea, as well as urgency,” Joelle BouSaba, MD, from the Department of Quantitative Health Sciences at Mayo Clinic in Rochester, Minnesota, and colleagues wrote in Clinical gastroenterology and hepatology. “These symptoms interfere with daily activities, and the impact is confirmed on a rigorous regression model. The study adds to the body of evidence, including the impact on healthcare utilization, that seeking evidence of BAD is relevant in patients with IBS-D, particularly in those with more severe and frequent diarrhea associated with urgency. Read more.

VIDEO: Trulance Significantly Improves CIC and IBS-C Abdominal Symptoms

In this exclusive video, Gregory S. Sayuk, MD, MPH, discusses the impact of Trulance on pain, discomfort, and bloating in patients with chronic idiopathic constipation and IBS with constipation.

Sayuk, an associate professor of medicine and psychiatry and associate director of the fellowship training program at Washington University School of Medicine and a gastroenterologist at John Cochran Veterans Affairs Medical Center, both in St. Louis, presented the research at the 2021 CAG Annual Scientific Meeting. Read more.

The future of IBS care relies on a multidisciplinary and integrative “team sport” approach

As knowledge of IBS has advanced, the traditional focus on abnormalities in motility and visceral sensation has evolved to include psychosocial distress and food as the most important triggers that worsen symptoms. Although one or more of these factors are demonstrable in most IBS patients, none can explain the symptoms in everyone.

“The diagnosis of IBS is based on the identification of characteristic symptoms and the exclusion of other organic diseases”, William D. Chey, MD, FCAE, of Michigan Medicine, and colleagues wrote in a JAMA Clinical examination of IBS. “Management of patients with IBS is optimized through an individualized and holistic approach that encompasses dietary, lifestyle, medical, and behavioral interventions.” Read more.

VIDEO: Linaclotide Provides Early Reduction of IBS with Constipation Symptoms

At the 2021 CAG Annual Scientific Meeting, Darren M. Brenner, MD, reported that linaclotide reduced abdominal pain and other symptoms of IBS with constipation within 4 weeks of treatment.

“It is important to note that if you allow the patient to continue taking the drug for more than 4 weeks, you may see improvements in 10% to 15% of individuals thereafter in their abdominal or bowel symptoms” , Brenner said. Read more.

Low FODMAP powders help control IBS and detect triggers

Use of low-FODMAP powders helped control symptom severity, somatization and depression in IBS patients in a tertiary care setting, according to findings presented at the 2021 Virtual Week of the UEG.

“Blind reintroduction using powders allows for the most objective identification of individual FODMAP triggers,” Karen Van den Houte, PhD, a researcher at KU Leuven in Belgium, said in his presentation. Read more.

VIDEO: Use “positive” language to diagnose IBS patients

In this exclusive video from the CAG Annual Scientific Meeting 2021, Brian E. Lacy, MD, PhD, FCAE, from the Mayo Clinic in Jacksonville, Florida, emphasized the importance of positivity and encouragement when diagnosing patients with IBS.

“Be positive with the diagnosis, educate your patient, reassure them, and remember that if you need to get tested, you can start treatment early,” Lacy said. “Don’t wait for all the tests to be done before starting treatment. Begin treatment based on the predominant symptom. ” Read more.